Vision and Pathways

S Gautam

Vision

Pathways

Superior Temporal Quadrantanopia

• How is it caused at the optic chiasm?

Pupils

• Horner’s Syndrome– Sympathetic injury– One sided pupillary constriction – Ptosis

Caused by anything injuring sympathetic chain or pathway

• Homes Adie Pupil– Postganglionic parasympathetic nerve

damage– Tonically dilated pupil– Slow to constrict– Absent tendon reflexes– Excessive sweating

• Argyll Robertson Pupil – Prostitute’s pupil (accommodates but

doesn’t react)– Specific to syphilis (treponema pallidum)– Uncommon these days

Amaurosis Fugax

• Sudden visual loss

• Painless

• Fleeting to minutes

• ‘Curtain’ across the vision

• Ipsilateral carotid or ophthalmic artery

• Holmes Adie Pupil

Vitreous Haemorrhage

• Painless loss of vision

• Unilateral

• Floaters, cobweb, haze, shadow

• High myopia risk factor

• Can be precursor for detachment

Retinal Vein Occlusion

• Loss of vision

• Usually on awakening

• Underlying coag. disorders

• Flame haemorrhages

• Risk Factors– DM– Smoking– Hyperlipidemia

Retinal Artery Occlusion

• Almost instant loss of vision

• Painless

• Usually elderly >60

• Pale retina

• Cherry red spot (foveola)

• Preceding amaurosis fugax

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